HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /-
Permit Number:
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort pierce FL 34982
Phone: (772) 462-155.3 Fax: (772) 462-1578 commercial Residential
PERMIT TYPE: 0; tom,
PROPOSED IMPROVEMENT LOCATION:
Address: N I 1J'A.
Property Tax ID #: 332-1 - 'Y3 L _ po 3
Site Plan Name:
Project Name: r— 6"
DETAILED DESCRIPTION OF WORK
maj C_
L(,, _
CONSTRUCTION INFORMATION:
- 000 -LI
Lot No. -2- 3
Block No.
Additional work to be performed under this permit- check all that apply:
_Mechanical — Gas Tank — Gas Piping — Shutters
Electric ^ Plumbing — Sprinklers
Total Sq. Ft of Construction:
Cost of construction: $ 21 '�>�l n
w Generator
Sq. Ft. of First Floor:
�< Windows iDoor
__
Roof Pitch
Utilities: _Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Imo
Name: C_,: -i--,
Address: 3 3,,,�Zi
Company:
city: _pf) r- J ci"' L State. Address: Z2--?,
Zip Code:,3 �-1 f,,V (� Fax: city:1--v CO J-
�� LPhone No. '�7
Z - ,. _ Zip Code:,134, T Fax: State -
E -Mail: Phone No Z"I L --6-1 L_�`C)
Fill in fee simple Title Holder on next page ( if different E -Mail C_J r bu ; P f' C_ 6 01
from the Owner listed above) State or County License 5! C 2
/-7
If value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW
INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY:
Address:
Name:
City:
Address:
State:
zip: Phone
City:
Zip: phone:_
FEE SIMPLE TITLE HOLDER:IVot Applicable
BONDING COMPANY:
Name:
Address:
Name:
City:
Address:
Zip: Phone:
City:
Zip: Phone:
ANot Applicable
State:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit..
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of ti,
e granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
IiPITH YOUR LENDER OR AN ATTORNEY BEFORE REC RDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner I Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORID
COUNTY OF � '�'1 COUNTY OF �,1-k, }
The forgoing instru t Fwas acknowledged before me The forgoing instr ent as acknowledged before me
this day of [ 2Q ' by this /C) day of ' !L 261- D by
Name of person making statement.
Name of person making statement.
Personally Known_ ,X OR Produced Identification
Type of Identification
Produced
ature of Notary Public_Stat�
Commission No. SADiNI
:.; Mft�IOff 3GWG 2742t
EXPIRE8: MM09w 26, 2022
REVIEWS I FRONT CO NTER I R VI W SUPERVISOR�ZONING REV---IEW
—
RECEIVED
DATE
COMPLET
Personally Known_ OR Produced Identification
Type of Identification
Produced
nature of Notary Public- State of Florida
mmission No.
lulY (0M%� 2742112
�• 1�1 Npyerriber 25, 2i)22
PLANS VEGETATI RILE MANGROVE
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